Staff turnover at youth homes makes job more perilous

Second in a series

June 27, 2011 4:00 AM

Bradley C. Bower/For the Post-Gazette

Daniel Elby, right, CEO of Alternative Rehabilitation Communities, speaks with student Danny R. outside the A.R.C. Woodland home in Harrisburg. The agency's residential program for dependent and delinquent youth has been called a model to follow.

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With little warning, the girl attacked a staff member at a Zelienople facility, scratching his face and grabbing his shirt to pull him to the ground.

The man tried to put his hands in front of his body "to defend himself," according to a report filed by the state-licensed residential program, Glade Run Lutheran Services. But in the scuffle, he lost his balance. He fell on top of the girl as she continued to fight.

The March 9, 2010, incident illustrates what staff members at youth residential facilities will tell you in a heartbeat: Their jobs are demanding and dangerous. Working long shifts for as little as $10 an hour, staff in these privately owned, publicly funded institutions face tough decisions daily and harsh repercussions if something goes wrong.

After the incident at Glade Run, the girl claimed the worker she attacked had abused her, saying that he had "lumped her head up." Even when such allegations are deemed "unfounded" by state investigators, they can still cost workers their jobs, according to 361 incident reports obtained by the Pittsburgh Post-Gazette.

The incident reports, released by the Pennsylvania Department of Public Welfare, show that despite years of good-faith efforts, children in residential facilities continue to face danger at the hands of staff members and peers, as well as their own. But the reports also reveal that workers in these facilities -- which house abused and neglected children, juvenile delinquents and other youth with profound needs -- risk physical injury on a regular basis. They've been punched, kicked and even stabbed with pens by children in their care.

With high rates of burnout, staff members in the state's 767 youth residential programs quit or are fired often: sometimes within days, usually after a handful of years, according to interviews with officials, private providers and former staff members.

"There's big turnover, because they won't pay people what they're worth," said Robin Williams, who quit his job at a McKeesport facility, Auberle, in December 2009. With a bachelor's degree and six years of service, he earned $13.27 an hour, no longer worth "all the hassle and the headaches," he said.

Hiring skilled people, training them well and getting experienced workers to stay is the first and most important battle that private residential care providers face.

"You can't have bare-bones staff," said Jim Rieland, former director of Allegheny County probation and a consultant in the field. "And when you talk about staff, that's the most expensive part of this whole operation."

But as revenues drain, understaffing has reached "near-emergency" levels in some facilities, undermining efforts to keep children safe, according to state inspection reports and numerous facility directors.

Auberle CEO John Lydon said he would not argue with Mr. Williams' assertion that his program was understaffed.

"We need to have twice as many people as we do," he said. "We exceed all the state mandates, but at the same time, we need more people."

Danger and self-defense

In August 2006, a worker at a branch of The Bradley Center, in Robinson, was strangled until she lost consciousness and sexually assaulted by a teenage resident, according to court documents and news articles. She sued the agency. In response, lawyers for The Bradley Center wrote that "due to the nature of services provided," the boy's actions constituted "a hazard normally expected to be present in the workplace."

There were at least 264 injuries to children in Western Pennsylvania facilities from January 2005 to December 2010, according to the incident reports obtained by the Post-Gazette. It is impossible to determine how many injuries to staff there were during the same time period; facilities are not required to report staff injuries to the Department of Public Welfare.

One former worker at a local facility, who spoke anonymously, described taking two separate trips to emergency rooms for treatment after confrontations with youth.

Staff members are told repeatedly that child safety comes before their own safety.

"I hear you," the former worker said. "But if I have a kid who punches out a window, grabs a shard of glass and tries to cut me? All bets are off."

Staff members who defend themselves can end up jobless or legally liable, said Mr. Williams, the former Auberle worker.

Mr. Williams quit in protest after a teacher at the program's school was fired because of a youth's accusation, he said. The 280-pound boy moved as if he was going to hit the teacher, the teacher physically restrained him, and the boy's aunt threatened a lawsuit, according to Mr. Williams.

To prevent a child from hurting himself or others, staff members are permitted by state regulations to restrain a child, using their hands to restrict his movement or hold him on the floor.

"I put in my two weeks notice on the same day they fired him," Mr. Williams said of his colleague.

Sometimes workers get "targeted," swept into accusations by an angry child, said Peggy B. Harris, president and CEO of Three Rivers Youth, a Pittsburgh-area provider.

"I remember a case where the person went through, in their mind, the humiliation of being implicated -- it turned out there was no finding -- and that person was not able to continue because they didn't feel they had credibility with the kids, or even amongst their peers," Ms. Harris said. "They felt like they'd been criminalized."

In this environment, staff members must be exceptionally well-trained to diffuse disputes, said Marcia Sturdivant, head of Allegheny County's Office of Children, Youth and Families.

"It takes some maturity and experience," Dr. Sturdivant said. "But, unfortunately, a lot of the people that work there are fresh out of college."

Hiring, training, retaining

The first hurdle facilities face is hiring "folks that have the credentials," said Bernadette Bianchi, executive director of a membership association of providers, the Pennsylvania Council of Children, Youth and Family Services.

At the very least, staff members must pass a child abuse clearance and criminal background check. Even then, it is difficult to determine whether someone is cut out for the job, facility directors said.

"How do you pick that in advance?" said Mr. Lydon. "We actually find it takes us about 30 days as you're going through training to figure out, are you going to be good at this or not?"

Ashley Hartman, 20, of Mount Oliver, who lived in residential programs as a teenager, said facility directors need to work harder to scrutinize the passion of potential workers.

"When I walk into certain places, I still see staff that are too young ... that act like teenagers, that get in between the gossip and the drama," said Ms. Hartman, who works as a Youth Support Partner for Allegheny County CYF, helping girls navigate the child welfare system.

"I understand it's a difficult job, but I think you need to have a certain type of heart," Ms. Hartman said.

When facilities find good workers, the second hurdle they face is keeping them, Ms. Bianchi said.

"This is very challenging and emotionally draining work," she said.

It is not unheard of for staff members to quit or be fired within days, facility directors and former workers said. As a norm, an agency might lose 35 percent of its workers in a given year, Ms. Harris said.

Last year, a DPW inspection of the Abraxas Center for Adolescent Females in Wilkinsburg found that the turnover rate for the month of May alone was 21.5 percent.

"Client safety was routinely being compromised," the state inspectors wrote.

"The chronic issue of insufficient staffing had risen to a near emergency level, making it impossible for staff to provide consistent supervision, much less, meaningful programming to clients."

A spokesman for The GEO Group, an international correctional company that acquired Abraxas last year, declined to make Abraxas officials available for comment.

State code mandates that one child care worker be present during waking hours for every eight children over the age of 6.

So when staff quit, facilities must act quickly to hire replacements.

"You give them a lot of training, a lot of support, they get good and then they want to move on to something else ...," said Susanne Cole, president and CEO of Pressley Ridge, a provider with facilities in several states. "Then you're constantly in this training and hiring mode."

Ms. Bianchi said minimizing risk "usually comes down to being able to retain staff."

"More experienced staff give you better outcomes, and there's research to show that," she said.

Because of that, continually training new workers makes it difficult to follow through on safety initiatives, said Gene Wisinski, CEO of Bethesda Children's Home in Meadville.

"Are they doing a good job? Do they get it?" he asked. "It starts the whole cycle all over for you of where you're vulnerable."

Money and morale

In recent years, many agencies that provide residential care have hit a financial wall, hobbled by declining youth populations and stagnant rates of payment per child.

As a result, the struggle to keep staff members has become even harder, according to numerous facility directors.

"We believe in this concept of a just wage," said Charles Lockwood, president and CEO of Glade Run, the Zelienople facility. "It's just hard to do that when your costs are choking you to death."

Mr. Lydon said money is not the most important factor in keeping staff, though: "We talk a lot about morale."

During the past five years, Three Rivers Youth reduced turnover significantly by creating an incentive program that encouraged peer recognition, Ms. Harris said. Staff stay for 7.8 years on average now, compared to 3.8 years in the past, she said.

The key is hiring people who truly enjoy the work, said Daniel Elby, CEO of Alternative Rehabilitation Communities in Harrisburg. Staff members stay for 12 to 15 years on average in his programs, Mr. Elby said.

"They like what they do, and they can see what they're doing is making a difference with the young people who we have," he said.

Despite the occasional "bad apple," workers in residential facilities are for the most part "really special people," said Mr. Lydon, the Auberle CEO.

"They clearly don't do it for the money," he said. "They clearly don't do it for the working conditions. In some of the programs, we don't have air conditioning."

"Sometimes those people get lost in the story."

Correction/Clarification: (Published June 28, 2011) A sexual assault to a worker at The Bradley Center in August 2006 occurred at the program's Robinson campus, which is still open. A story Monday about injuries to staff in state-licensed residential facilities misidentified the incident's location